Dr Khan Lamia Nahid, Associate Professor, Department of Paediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2022 Oct;31(4):1206-1211.
Solitary rectal ulcer syndrome (SRUS) is an uncommon benign rectal disorder. Typically, young adults are affected and it is rare in children. Straining during defecation, self-induced trauma and paradoxical contraction of puborectalis muscle are the major contributing factors of this condition. Clinical features of SRUS are rectal bleeding, mucorrhoea, excessive straining during defecation, tenesmus, feeling of incomplete defecation and constipation. A complete and thorough history is most important for diagnosis of SRUS. Rectal bleeding may be misinterpreted as originating from an anal fissure caused by constipation or as other causes of rectal bleeding such as a juvenile polyp. The best and most accurate diagnostic method of SRUS is rectal biopsy. The major histological feature of SRUS is fibromuscular obliteration of the lamina propria. Avoiding straining, regular toilet habit, use of bulk laxatives, steroid and sucralfate enemas are the mainstay of treatment. Biofeedback mechanism is another treatment option. Because the clinical presentation varies, the diagnosis requires a high index of suspicion for both the clinician and the pathologist.
孤立性直肠溃疡综合征（SRUS）是一种罕见的良性直肠疾病。通常，年轻人易患此病，而儿童则很少见。排便时用力、自我创伤和耻骨直肠肌的反常收缩是导致这种情况的主要因素。SRUS 的临床特征包括直肠出血、黏液便、排便时过度用力、里急后重、排便不尽感和便秘。全面详细的病史对 SRUS 的诊断最为重要。直肠出血可能被误诊为由便秘引起的肛裂，也可能被误诊为其他直肠出血的原因，如幼年性息肉。诊断 SRUS 的最佳和最准确的方法是直肠活检。SRUS 的主要组织学特征是固有层的纤维肌肉闭塞。避免用力、养成规律的排便习惯、使用容积性泻剂、类固醇和硫酸蔗糖灌肠是治疗的主要方法。生物反馈机制是另一种治疗选择。由于临床表现多样，因此临床医生和病理医生都需要高度怀疑才能做出诊断。
